Yoga as an useful component in COPD therapy
Multidisciplinary treatments have led to great results in pneumological rehabilitation. Concomitant yoga therapy has improved lung function and QoL.
The Pneumology Blog
By Dr. med. Sophie Christoph
Yoga influences endurance and blood circulation
- Sports and training therapy contributes to building aerobic capacity and extremity muscles and thus to better resilience in everyday life.
- Yoga, on the other hand, focuses on strengthening the torso, breath control, mindfulness and self-awareness.
- Yoga, especially yoga breathing techniques, can be an effective complementary measure for patients with COPD.
Physical and mental training (at least) as important as drug therapy
The effectiveness of sports and exercise therapy for both the physical and mental consequences of COPD is very well established. It contributes to a reduction in resting and exertional dyspnoea, an increase in exercise tolerance and an improvement in quality of life. Exercised patients are less likely to require emergency medical treatment or hospitalisation. Therefore, sport and physical training are a regular part of rehabilitation or should always be part of the normal long-term outpatient treatment of these patients.1
Yoga has been shown to have a number of health benefits for people with COPD. A systematic review that evaluated 10 controlled trials suggested an improvement in 6-minute walking distance.2 Other papers reported improvements in one-second capacity (FEV1) and partial pressure of carbon dioxide in arterial blood (paCO2).3,4 In addition, there is at least evidence of a link between yoga and a decrease in airway inflammation, as reflected in changes in fractional exhaled nitric oxide (FENO) and TNFα.5
Given the global and progressive disease burden of COPD, access to exercise and rehabilitation is critical, yet in reality the need remains unmet. The principles of pneumological rehabilitation and yoga complement each other, and the latter once again offers important differences in terms of intensity of activity, type of exercise and incorporation of mindfulness - and can be practiced by oneself in the home setting.
An integrated approach can lead to optimal access and implementation
Yoga is an ancient pre-Vedic science and in its true sense means the union of body and mind. Yoga is traditionally known as a psychosomatic practice for general well-being. The therapeutic potential of yoga has been studied for the last five decades in the treatment of various diseases, demonstrating its positive effects.6,7 Yoga is a mostly low-impact practice that increases blood flow, as the bends, compressions and stretches direct blood flow to specific organs. Full yoga breathing promotes optimal oxygenation of the blood.
However, meditation and movement techniques such as Qi Gong, Tai Chi or regional dance forms (e.g. Haka) also achieve similar results. Another systematic review of 16 controlled studies examining yoga, tai chi and qigong showed effects on dyspnoea, lung function, physical performance and quality of life.8
In several countries, yoga has long been recommended by national health organisations as a safe and effective way to promote physical activity, improve strength, balance and flexibility not only for respiratory conditions, but as potentially beneficial for people with hypertension, heart disease, pain, depression and stress.6 The road ahead would be a more widespread application as part of an integrated approach for clinical practice treatments.
References:
1. Rehabilitation bei COPD - Deutsche Patientenliga Atemwegserkrankungen - DPLA e.V. (In German only)
2. Sahasrabudhe, S. D. et al. Potential for integrating yoga within pulmonary rehabilitation and recommendations of reporting framework. BMJ Open Respiratory Research 8, e000966 (2021).
3. Cramer, H. et al. The risks and benefits of yoga for patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Clin Rehabil 33, 1847–1862 (2019).
4. Li, C., Liu, Y., Ji, Y., Xie, L. & Hou, Z. Efficacy of yoga training in chronic obstructive pulmonary disease patients: A systematic review and meta-analysis. Complement Ther Clin Pract 30, 33–37 (2018).
5. Thokchom, S. K., Gulati, K., Ray, A., Menon, B. K., & Rajkumar. Effects of yogic intervention on pulmonary functions and health status in patients of COPD and the possible mechanisms. Complementary Therapies in Clinical Practice 33, 20–26 (2018).
6. McCall, M. C., Ward, A., Roberts, N. W. & Heneghan, C. Overview of Systematic Reviews: Yoga as a Therapeutic Intervention for Adults with Acute and Chronic Health Conditions. Evidence-Based Complementary and Alternative Medicine 2013, e945895 (2013).
7. Desveaux, L., Lee, A., Goldstein, R. & Brooks, D. Yoga in the Management of Chronic Disease: A Systematic Review and Meta-analysis. Medical Care 53, 653–661 (2015).
8. Wu, L.-L. et al. Effectiveness of meditative movement on COPD: a systematic review and meta-analysis. COPD 13, 1239–1250 (2018).